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Hamstrung--or not.

Several years ago I pulled the hamstrings on both legs. I slipped on a rock and fell into a splits position (not while running). My doctor advised me to start a flexibility program to stretch the hamstrings during the healing process so that they would not shorten as a result of the injury. While I was able eventually to return to my regular mileage, my hamstrings have given me trouble since and as a result limit my running. Now I have trouble sitting for any length of time before my hamstrings begin to ache. The pain is at the upper attachment of the muscle. At times the entire buttocks and sacroiliac are flooded with a dull pain.

Charles Stinson

Cambria, IL

Hamstrings injuries can be difficult to heal and often require a more comprehensive approach to rehabilitation. Strengthening the muscles is as important as maintaining flexibility. Since the hamstring acts on both the knee and the hip, it is important to do hamstring strengthening exercises for both knee flexion and hip extension. Exercises should be performed in both a concentric and eccentric fashion, that is, exercises should activate the muscles while they are shortening and lengthening. This can be accomplished by performing exercises with both a slow up and a slow down motion. Compression shorts or a compressive thigh sleeve may also help alleviate some of your discomfort.

However, you may be acting on an erroneous assumption at this point. Your hamstring problems are getting worse with symptoms extending beyond the original injury. Buttock and sacroiliac pain suggest that the lumbar spine may be involved and you may need to be evaluated by a physician who has expertise both in sports injuries as well as the lumbar spine. Sciatic nerve impingement (pressure on the sciatic nerve from the spine) can cause the symptoms you describe including pain in the low back, buttocks and hamstrings, and these problems would require treatment different from the treatment for a chronic hamstring pull. Make sure that your doctor has considered and ruled out all the possible causes of pain in this region.

Robert Wilder, M.D.

Charlottesville, VA
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Publication:Running & FitNews
Date:Sep 1, 2002
Words:354
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